Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T04:40:30.506Z Has data issue: false hasContentIssue false

Elderly suicide attempters by self-poisoning in Korea

Published online by Cambridge University Press:  01 March 2011

Yoo-Ra Kim
Affiliation:
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Kyoung Ho Choi
Affiliation:
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Youngmin Oh
Affiliation:
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Hae-Kook Lee
Affiliation:
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Yong-Sil Kweon
Affiliation:
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Chung Tai Lee
Affiliation:
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
Kyoung-Uk Lee*
Affiliation:
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
*
Correspondence should be addressed to: Professor K.U. Lee, Department of Psychiatry, The Catholic University of Korea, Uijeongbu St. Mary's hospital, Geumo-dong 65–1, Uijeongbu, Gyeonggi-do, Republic of Korea. Phone: +82–31-820–3609; Fax:+82–31-847–3630. Email: [email protected].
Get access

Abstract

Background: Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters.

Methods: Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review.

Results: The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004).

Conclusion: Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2004). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Chen, V. C. et al. (2009). A community-based study of case fatality proportion among those who carry out suicide acts. Social Psychiatry and Psychiatric Epidemiology, 44, 10051011.CrossRefGoogle ScholarPubMed
Conwell, Y. and Thompson, , , C. (2008). Suicidal behavior in elders. Psychiatric Clinics of North America, 31, 333356.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R., Cox, C., Herrmann, J., Forbes, N. and Caine, E. D. (1998). Age differences in behaviors leading to completed suicide. American Journal of Geriatric Psychiatry, 6, 122126.CrossRefGoogle ScholarPubMed
De Leo, D. and Spathonis, K. (2003). Suicide and euthanasia in late life. Aging Clinical and Experimental Research, 15, 99110.CrossRefGoogle ScholarPubMed
Dombrovski, A. Y., Szanto, K., Duberstein, P., Conner, K. R., Houck, P. R. and Conwell, Y. (2008). Sex differences in correlates of suicide attempt lethality in late life. American Journal of Geriatric Psychiatry, 16, 905913.CrossRefGoogle ScholarPubMed
Duberstein, P. R., Conwell, Y., Conner, K. R., Eberly, S. and Caine, E. D. (2004). Suicide at 50 years of age and older: perceived physical illness, family discord and financial strain. Psychological Medicine, 34, 137146.CrossRefGoogle ScholarPubMed
Hepple, J. and Quinton, C. (1997). One hundred cases of attempted suicide in the elderly. British Journal of Psychiatry, 171, 4246.CrossRefGoogle ScholarPubMed
Hunt, I. M. et al. (2010). Method of suicide in the mentally ill: a national clinical survey. Suicide and Life-threatening Behavior, 40, 2234.CrossRefGoogle ScholarPubMed
Ilgen, M. A., Zivin, K., McCammon, R. J. and Valenstein, M. (2008). Pain and suicidal thoughts, plans and attempts in the United States. General Hospital Psychiatry, 30, 521527.CrossRefGoogle ScholarPubMed
Kim, M. H., Jung-Choi, K., Jun, H. J. and Kawachi, I. (2010). Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Social Science and Medicine, 70, 12541261.CrossRefGoogle ScholarPubMed
Kwon, J. W., Chun, H. and Cho, S. I. (2009). A closer look at the increase in suicide rates in South Korea from 1986–2005. BMC Public Health, 9, 72.CrossRefGoogle Scholar
Lee, W. J., Cha, E. S., Park, E. S., Kong, K. A., Yi, J. H. and Son, M. (2009). Deaths from pesticide poisoning in South Korea: trends over 10 years. International Archives of Occupational and Environmental Health, 82, 365371.CrossRefGoogle ScholarPubMed
Li, X., Xiao, Z. and Xiao, S. (2009). Suicide among the elderly in mainland China. Psychogeriatrics, 9, 6266.CrossRefGoogle ScholarPubMed
McIntosh, J. L. (1992). Older adults: the next suicide epidemic? Suicide and Life-threatening Behavior, 22, 322332.CrossRefGoogle ScholarPubMed
McLaren, S. and Challis, C. (2009). Resilience among men farmers: the protective roles of social support and sense of belonging in the depression-suicidal ideation relation. Death Studies, 33, 262276.CrossRefGoogle ScholarPubMed
Misson, H. et al. (2010). Factor analyses of the Suicidal Intent Scale (SIS) and the Risk-Rescue Rating Scale (RRRS): toward the identification of homogeneous subgroups of suicidal behaviors. Journal of Affective Disorders, 121, 8087.CrossRefGoogle ScholarPubMed
Penninx, B. W., van Tilburg, T., Deeg, D. J., Kriegsman, D. M., Boeke, A. J. and van Eijk, J. T. (1997). Direct and buffer effects of social support and personal coping resources in individuals with arthritis. Social Science and Medicine, 44, 393402.CrossRefGoogle ScholarPubMed
Penninx, B. W., Van Tilburg, T., Boeke, A. J., Deeg, D. J., Kriegsman, D. M. and van Eijk, J. T. (1998). Effects of social support and personal coping resources on depressive symptoms: different for various chronic diseases? Health Psychology, 17, 551558.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorensen, S. (2001). Gender differences in self-concept and psychological well-being in old age: a meta-analysis. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 56, 195213.CrossRefGoogle ScholarPubMed
Ratcliffe, G. E., Enns, M. W., Belik, S. L. and Sareen, J. (2008). Chronic pain conditions and suicidal ideation and suicide attempts: an epidemiologic perspective. Clinical Journal of Pain, 24, 204210.CrossRefGoogle ScholarPubMed
Salib, E. and Green, L. (2003). Gender in elderly suicide: analysis of coroners’ inquests of 200 cases of elderly suicide in Cheshire, 1989–2001. International Journal of Geriatric Psychiatry, 18, 10821087.CrossRefGoogle ScholarPubMed
Shah, A. (2010). A replication of the curvilinear relationship between population growth and elderly suicide rates in a cross-national study. International Psychogeriatrics, 22, 337338.CrossRefGoogle Scholar
Shin, S. D., Suh, G. J., Rhee, J. E., Sung, J. and Kim, J. (2004). Epidemiologic characteristics of death by poisoning in 1991–2001 in Korea. Journal of Korean Medical Science, 19, 186194.CrossRefGoogle ScholarPubMed
Shiner, M., Scourfield, J., Fincham, B. and Langer, S. (2009). When things fall apart: gender and suicide across the life-course. Social Science and Medicine, 69, 738746.CrossRefGoogle ScholarPubMed
Szanto, K., Gildengers, A., Mulsant, B. H., Brown, G., Alexopoulos, G. S. and Reynolds, C. F. III (2002). Identification of suicidal ideation and prevention of suicidal behaviour in the elderly. Drugs and Aging, 19, 1124.CrossRefGoogle ScholarPubMed
Tadros, G. and Salib, E. (2000). Age and methods of fatal self harm (FSH): is there a link? International Journal of Geriatric Psychiatry, 15, 848852.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Weisman, A. D. and Worden, J. W. (1972). Risk-rescue rating in suicide assessment. Archives General Psychiatry, 26, 553560.CrossRefGoogle ScholarPubMed
Wu, Z. Q., Sun, L., Sun, Y. H., Tao, F. B. and Cui, G. H. (2010). Correlation and social relationship among empty nest elderly in Anhui rural area, China. Aging and Mental Health, 14, 108112.CrossRefGoogle ScholarPubMed
Yang, S., Khang, Y. H., Harper, S., Davey Smith, G., Leon, D. A. and Lynch, J. (2010). Understanding the rapid increase in life expectancy in South Korea. American Journal of Public Health, 100, 896903.CrossRefGoogle ScholarPubMed
Zanni, G. R. and Wick, J. Y. (2010). Understanding suicide in the elderly. Consultant Pharmacist, 25, 93102.CrossRefGoogle ScholarPubMed
Supplementary material: File

Kim Supplementary Material

Kim Supplementary Appendix

Download Kim Supplementary Material(File)
File 52.7 KB